Hip strengthening exercise compared to standard rehabilitation after revision hip replacement: a multicenter randomized controlled trial

Key Points

1. Hip strengthening–based treatment is not superior to community-based rehabilitation after revision total hip replacement (THR).

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BACKGROUND & OBJECTIVE

Revision after primary total hip replacement (THR) is a complex procedure, most performed due to aseptic loosening, dislocation, fracture, or infection (1). The burden of revision THR is increasing, with an estimated 572,000 procedures projected annually in the United States by 2030.

Although rehabilitation is essential for optimizing recovery, post-revision THR practices lack standardization and are often guided by individual physiotherapist judgment or local resource availability. Neuromuscular exercise (NEMEX) improves pain, physical function, and quality of life in hip osteoarthritis, but its effectiveness in patients undergoing revision THR remains unknown.

This study aimed to compare the effectiveness of a hip strengthening exercise intervention (NEMEX-STR) versus standard community-based rehabilitation (usual care) on functional performance at four months in individuals undergoing revision after primary THR.

The burden of revision Total Hip Replacement is increasing, with an estimated 572,000 procedures projected annually in the United States by 2030.

Clinicians should actively involve their patients in the decision-making process for rehabilitation by exploring how they feel about exercise and asking important key questions.

METHODS

This study was a multicenter, randomized, controlled, parallel-group, assessor-blinded superiority trial. Following baseline assessment and surgery, participants were randomized to NEMEX-STR or Usual care. Outcomes were assessed at baseline (before revision THR) and at four months after initiation of the

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